非职业性慢性汞中毒周围神经损害的临床表现及电生理特征

目的 评价非职业性慢性汞中毒患者周围神经损害的临床表现及其神经电生理特征.方法 选取军事医学科学院附属医院神经内科2011年12月～2013年9月收治的慢性汞中毒患者31例为中毒组,选取年龄、性别匹配的31例健康体检者为对照组.收集两组的相关资料并进行比较分析.结果 慢性汞中毒患者周围神经损害的临床表现以肢体无力、疼痛、麻木为主.运动神经检测显示中毒组正中神经、尺神经、腓总神经远端潜伏期较对照组延长,正中神经、尺神经、腓总神经传导速度减慢,差异有统计学意义（P＜0.01或P＜0.05）.感觉神经检测显示中毒组腓肠神经、正中神经潜伏期较对照组延长,尺神经、桡神经波幅降低,腓肠神经、正中神经、尺神经、桡神经传导速度减慢,差异有统计学意义（P＜0.01或P＜0.05）.结论 非职业慢性汞中毒性周围神经损害起病隐匿,神经电生理检查能够无创、客观地反映患者的周围神经损害程度.

Clinical and electrophysiological features of the peripheral nerve damage in patients with chronic non-occupation mercury poisoning

ObjectiveTo evaluate the clinical and electrophysiological features of the peripheral nerve damage in patients with chronic non-occupation mercury poisoning. Methods 31 cases of chronic non-occupation mercury poisoning patients were selected randomly at Affiliated Hospital of Academy of Military Medical Sciences between December 2011 and September 2013.31 age, sex matched healthy persons were selected as control group. The main index of patients in each group were retrospectively analyzed and compared. Results The clinical manifestations of peripheral nerve damage in this group of patients was mainly wakeless, pain and numb of limb. Motor nerve detection showed in the poisoning group than in the control group, the prolonged distal latency of median, ulnar and common peroneal nerve, the slowed nerve conduction velocity of median, ulnar, common peroneal nerve, with significant statistical difference （P 〈 0.01 or P 〈 0.05 ）. Sensory detection showed in the poisoning group than in the control group the prolonged latency of sural and median nerve, the decreased amplitude of ulnar and radial nerve, the slowed nerve conduction velocity of sural, median, ulnar and radial nerve, with significant statistical difference （P 〈 0.01 or P 〈 0.05）. Conclusion The onset of peripheral nerve damage in patients with chronic nonoccupation mercury poisoning is insidious. Electrophysiological investigation can detect this impairment of peripheral nerve damage noninvasively and objectively.